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Departments of 1 Clinical Investigation and 2 Pediatrics, Tripler Army Medical Center, Honolulu 96859, and 3 Department of Pediatrics, Kapiolani Medical Center for Women and Children, John A. Burns School of Medicine, Honolulu, Hawaii 96826
Nebulized amiloride has been proposed as
therapy in cystic fibrosis to block
Na+ hyperabsorption in airway
epithelium and prevent dehydration of secretions. Patients with cystic
fibrosis often have reactive airways. Bovine and canine trachea relax
to amiloride in vitro, suggesting another benefit as a bronchodilator,
whereas guinea pig trachea, a useful model of human airways, does not.
We hypothesized that human airways would respond like guinea pig
airways. Airway ring segments from guinea pigs, mice, and human fetuses
were constricted with the concentration of acetylcholine producing
50-75% maximum contraction. Subsequent changes in isometric
tension to cumulative additions of amiloride
(10
8-10
4
M) were measured. Guinea pig airways contracted 29 ± 5%, mouse airways contracted 23 ± 6%, and human fetal airways contracted 30 ± 8%. Contraction to amiloride was mimicked by dimethylamiloride, a more selective inhibitor of the
Na+/H+
antiporter, and was attenuated by protein kinase C (PKC) inhibition with GF109203X and staurosporine. The present study indicates that
amiloride-induced airway contraction in guinea pigs and mice closely
parallels the response in isolated human airways and that the mechanism
may involve the
Na+/H+
antiporter and PKC.
airway smooth muscle; cystic fibrosis; diuretics; Na+/H+ exchange; protein kinase C
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